Mr. Menicoche.
I’m pleased to see that at least the facilities will be addressed and looked at. What is the timeline to begin this work for the Fort Simpson Health Centre?
Ms. Lee.
I appreciate that really the detailed discussion we’re having is for this fiscal year, but as I stated to the public of Simpson residents who showed up at our meeting when we visited with the Member, the Fort Simpson facility needs significant work on its foundation and renovation. It will be out for planning study up next, the Simpson facility.
Next I have Mr. Ramsay.
Thank you, Mr. Chairman. I just wanted to weigh in, I guess, on the fact that the Stanton Master Development Plan is not included in the capital plan again this year, to my great disappointment. That was an item that appeared in the capital plan for a number of years running. It was taken out for whatever reason that was given at the time. I think it was to study things a little bit further, analyze this or look at that. Some excuse was given why that was taken out. The bottom line is that decisions are being made on a day-to-day basis, operational decisions at that hospital, which is the flagship of our health care system in the Northwest Territories. In the absence of any grand master plan and how those decisions ultimately would fit into that plan, and obviously it’s not done and isn’t appearing anywhere in the capital plan or on the horizon, I guess I just wanted to make that point again this year. I know the Minister has already answered the question that Mr. Abernethy has asked her about the master plan. She doesn’t have to answer it again, because I heard the answer.
The other thing I wanted to talk about -- and this defies any logic, really, when you think about it -- the renovation to the health centre in Fort Smith and the replacement of the facility in Hay River, two communities that are very close together and service the same area. We’re basically replicating the level of service in each one of those communities. I’d like to ask the Minister maybe if she could, for the record, explain how it is or why it is that these scarce capital dollars are being used to replicate the provision of services in those two communities to the same degree within a short period of time from one another.
Minister of Health, Ms. Lee.
In many ways the Member’s question about Smith and Hay River is related to the work that we are doing in Stanton. Going forward what we need to do not only in programming but especially in the capital plan that’s before us, is that we need to have a system-wide plan and work on facilities, because facilities are built to support the services. What we need to do is make sure that Stanton becomes a true territorial hospital; a true acute care, tertiary, the only acute care facility. Inuvik will be the secondary, second level, high-level care facility. Sort of the hub-and-spoke model is the picture that we want to imagine. In that picture, Hay River, Fort Simpson, Fort Smith and Norman Wells will become regional health centres to support Stanton. All those facilities have a role to play.
We hear daily from Alberta and nationally that the health care system is under pressure. We need to be able to respond to demands that are going to be placed on our system, because as Alberta is under pressure, we’ll be asked to take on patients on short notice.
It’s really important that our regions have facility and system support to support our patients who don’t have to be at Stanton. In order to do that, we need to upgrade and modernize the facilities that we have in Hay River, Simpson, Smith and Norman Wells, along with Inuvik. We are working to make sure they all flow. It’s not necessarily duplication, it’s necessity to make sure we have these places in our regions so that we don’t send everybody to Stanton and we rely less on southern facilities.
I’m just wondering -- I was listening to the Minister’s response -- what region does she consider Fort Smith to be in. If they’re building up or maintaining the same level of service as the facility in Hay River, they’re in the same region the last time I looked at a map. They’re pretty close together. About an hour and a half to two hours on the highway. Is the intention of the facility in Fort Smith to service any communities in northern Alberta? What are we doing there?
I’m going to invite the deputy minister to add more to what I have to say. The Fort Smith centre is being renovated to meet the needs of the residents that it serves. The way it is designed now -- it was a hospital many, many years ago -- it is designed and being renovated to reflect the ISDM model and integrated services that we need to provide. We’re putting emphasis on the midwifery program there, which is serving the community well. There are residents from outside that are coming in to use that facility. We also want to be able to do other services. I don’t want to get into technical terms. Ms. Meade can add to that.
We will be building to fit the residents who we serve there as we would for Hay River. There’s a little bit of future projection required, because we want these facilities to be there to serve our residents for the next 10 to 20 years.
If the Member is worried about overbuilding, that will not happen. We are working very hard to make sure that all our facilities work at its maximum and that they work efficiently. A lot of renovations had to do with upgrading to meet the standards of the day to make sure we could do the scope work and focusing on aftercare when they come from more acute care facilities. Ms. Meade can add more to that.
Ms. Meade.
First, we’ll need all those beds when we do move into the master development; not the planning for Stanton but the actual doing. You’re going to be doing a redevelopment in a live hospital, so you do need to be able to decant patients and services.
The other piece of it is that with the 48-hour repatriation notice and Alberta is now moving to 11:00 a.m. discharges and raising their percentages in their hospitals because they’re so full. We have to be able to treat a bed in the Territories as a bed. By less services that are currently coming into Stanton from Fort Smith or Hay River, that will give us some of the more acute beds that we’re going to need for the rapid response.
Secondly, given the waitlists and the pressures on Stanton for some of the diagnostics, we hope to expand the diagnostics in both. Some differences, but for example, with dialysis we have a need to have dialysis. They are not duplicating. We have to have it in more centres than less. We’re also building with future expansion in both. Future meaning different services in the diagnostic area, should they be required.
Mr. Ramsay.
Maybe if the Minister could, I’m just having trouble understanding which of those two facilities is going to be considered the regional health care centre in the South Slave. Is it going to be Fort Smith or is it going to be Hay River?
Ms. Lee.
As I stated, we are designing a prototype that would go into, well, Smith is a little different because we’re renovating an existing facility. As I mentioned numerous times, we’re looking at a prototype for Level B-C health centre. That’s what’s going to go into Simpson. Well, that will be a renovation too. The functions that are going to be delivered in these programs are similar. So I don’t think it helps to say we don’t look at it as a region. We look at it as a community, we look at it as a health facility that’s going to serve residents in that area. We also look at these health facilities as part of the whole territorial system.
We want to be able to find or make sure that any services that are currently being delivered at Stanton, if they can be delivered elsewhere, we want to be able to do that there. We’ve already done that in Hay River. We’ve done our scope work there. We need to be focused on using all of our facilities better, because over a number of years a lot of stuff got done at Stanton that could be done elsewhere if properties support it.
The other part of the work that we’re doing is to have the long-term care facilities in all these regional centres. We’re enhancing that service in Smith and we are going to be incorporating that in Hay River. We have enhanced that in Simpson and we will have that in Norman Wells. It’s to serve the community and the surrounding area. I don’t think that anybody is saying that either Smith or Hay River Health Centre will become the regional health centre for the entire South Slave area.
Next on the list I have Ms. Bisaro.
Thank you, Mr. Chairman. I have a couple of questions with regard to this page. I’m a little confused. I want to follow up on Mr. Abernethy’s question about the expense for the GNWT office and records centre warehouse tenant improvements. When I read the justification for the expense, it sounded to me as though the tenant improvements were going to be in the Semmler Building, which I gather is where this particular program is now. So are the tenant improvements for this new building, which I kind of don’t think is built yet, or is it for the building that the division is currently in?
Ms. Meade.
Sorry, I probably was not clear on my response. It’s in the current building, the Semmler Building, that the leasehold improvements are at.
Thanks for that clarification. I have a general question regarding facilities and capital expenditures and so on. I presume this is the right place to make it.
Mr. Chairman, if you want me to wait until the summary comes up, I can, but I wanted to ask a question about the 20-year facilities needs study that the Minister mentioned earlier today and that has been mentioned in other conversations prior to today. I’d like to know if that study is complete. If so, when can Members get a copy of it? If it’s not complete, when is it expected to be done?
Ms. Lee.
Mr. Chairman, it’s complete. We sent an electronic version, because it’s quite massive, to the committee. Thank you.
I’d like to know from the Minister when that was sent. My concern is that, and I’m kind of following up from the discussion that I had with the Minister earlier today with regard to housing and facilities for adult disabled residents who need supervisory care, assisted living and so on. I didn’t get a sense from the Minister that this plan has any specific buildings or facilities identified for that sort of care. I guess I will wait until I see the plan to ask further specific questions, but if the Minister could advise when that plan was sent to committee and, I guess, also if the Minister can advise if there are any facilities in that plan scheduled to be built for assisted living. Thank you.
Just to answer the Member’s first question, as the Member knows, we did have a prior briefing on this and we did send some documents that the Member has asked for. I believe it was sent in an electronic version and I’m assuming those were made available. If not, I could make that available to the Member.
Secondly, I know what the Member is asking. I think she wants to see right in front of her how many beds in how many communities, in what communities, in what year for the next 20 years. I think what we need to discuss about long-term care. We know that the Department of Health along with Public Works has completed a long-term care facilities review that gives us a plan to go forward on where the population projections are and what the requirements should be for long-term care. When we are talking about long-term care, we often think of seniors’ care, but it also includes institutional caring or facility caring of people who cannot be taken care of otherwise.
But what I also need to tell the Members is that there are other ways of taking care of residents who need assistance, and a lot of that work is being done in Yellowknife already. We may not know it, but there are many streets in Yellowknife where there are group homes and they have them in other communities in a limited sense. My point is, there is more than one way of taking care of those residents who need assistance.
There is never enough space. There are always people on the waiting list, and how fast we move on that is a question of resource. That’s what we do every year, is to try to find money as the Legislature, to see how quickly we move that and how much budget we have allocated for them. The way to do that is to have a needs study, and we have just finished that needs study. It’s something that we need to work together on. The institutional setting is the last resource, I believe. Going forward, we want to put less and less people in these institutions. What we want to do is to be able to support them in other ways. I can undertake to provide the Member with how many beds we have in different communities to help persons with the need for assisted living that are not necessarily in institutions. Thank you.
I wasn’t necessarily asking for institution. I’d like to know if the Minister is referencing the capital needs assessment, the 20-year capital needs assessment. It’s a summary of all departmental needs. If that’s the document the Minister is referring to, yes, I have that, but I had understood her to be referencing a facilities needs study just for Health and Social Services. Could I get a clarification on which document she’s referencing? Thank you.
Mr. Chairman, that is the one I was referring to. Thank you.
Mr. Chair, I have to ask the Minister what that one refers to. Is it this document which I have in my hand, which is labelled Summary of Departmental Needs, Capital Needs Assessment, 20 Years, Five-Year Capital Planning Process? Thank you.
Mr. Chairman, I will do my best to answer questions. I will get back to her on all the documents I gave her. We gave a bunch of documents to the committee. There might be some breakdown in communication. Whatever she needs, whatever I have, whatever I can give her, I will give her.
In terms of long-term care facilities needs study, the Member knows that the department just finished looking at long-term care needs of the Territories for the next 20 years. We talked about the need to review that every five years. That was part of our discussion in the Standing Committee on P and P and Social Programs when we reviewed the capital plan. Thank you.
Thank you, Ms. Lee. I think the report that was being referred to was the report in regard to the review that was done by Public Works on the infrastructure of the department. If you can get that report, great. Ms. Bisaro.
Thank you, Mr. Chair. I guess I will have to figure out what document we’re talking about there.
My concern with the capital needs assessment for the capital planning process is that it only looks at existing buildings, and my concern is with the need to fill in this gap for assisted living as there is no indication in this document for any accommodation of persons who need assisted living with supervision.
I agree with the Minister that institutions should be the last place that people go, but certainly there should be some planning, in my mind, for homes, whether they be homes that are owned by Health and Social Services or owned by the Housing Corporation, and programs are run by Health and Social Services. But I don’t sense that we have a plan to deal with that anytime in the near future. Just a comment. Thank you, Mr. Chair. I’m done.
Thank you, Ms. Bisaro. Next I have Mr. Bromley.
Thank you, Mr. Chairman. Just a quick question on the small capital replacement, the evergreening sorts of things. This is sometimes a cumbersome process to put it through this sort of capital planning. Is there some thought to going to a routine evergreening process where we don’t have to examine each microscope being replaced, so to speak, please? Thank you.
The Minister of Health.
Thank you, Mr. Chairman. The current process is that we are part of the, sort of, replacement of small equipment, under $50,000, is it? Capital? But we are working to see if we could have a separate category for medical equipment, because they have different requirements and some of them are urgent. If something goes wrong, we need to be able to replace them, because otherwise our people do need those machines to do things or to do diagnoses or whether it’s an X-ray machine or… Anyway, we are working to separate that and come up with a different evergreening process for medical equipment, and I do really appreciate the support and the feedback that we’ve received from Members. Thank you.
That’s really all I had. I look forward to that coming forward and I certainly would support such a process. Streamlining would be appropriate here. Thank you.
Thank you, Mr. Bromley. Next I have Mr. Beaulieu.
Thank you, Mr. Chairman. Just a quick question in this area, health services programs. I was wondering if the Minister could advise if there is any planning study scheduled for the replacement of the health centres in both Fort Resolution and Lutselk'e.
The Minister of Health, Ms. Lee.
Thank you. As the DM mentioned earlier, we have reviewed every health facility in the Territories in the last year. Many of our facilities are over 30 years old and I can advise the Member that Fort Resolution is one of the ones that needs major renovations. As well, Lutselk'e is one that needs to be looked at in short order. It will be part of the next cycle of planning studies going through the process in the next two or three fiscal years. Thank you.
I just wanted to know if either of those two health centres are actually scheduled to a point of the planning study through the process. I see that there’s planning studies that do occur and then following the planning study, usually the following year there’s a determination of whether or not that’s something that should be replaced within that year or the next year or the year after or whatever. So at this point I’m just looking for the timing of the planning study for the two facilities.
As we’re all aware, we’re dealing with the capital plan for ‘11-12. The resolution planning study is up for next fiscal year as soon as possible, because it needs to get on the books. We are dealing with a land issue there and we know our review of the facilities show that Lutselk’e needs to be in the cycle by 2015.
Now, I can’t speak for what would happen for the future Assemblies, but our studies have shown that Lutselk’e is one of the five Level B facilities that needs to get into the next stage in the planning and the capital plan process. Thank you.
Mr. Chairman, am I eligible to ask questions from the next section, community health, or do we have to approve the page first?
Thank you, Mr. Beaulieu. I think we will complete this section first before moving onto that, community services. So I have next, Mr. Krutko.
Thank you, Mr. Chair. My question to the Minister is: I was surprised to hear a comment today, or a question of the Minister earlier today, in regard to long-term care facilities where we have residents from Nunavut in long-term care in the Northwest Territories. I’d like to know if there is a situation of number in the Northwest Territories, an increase in the numbers of elderly care, especially in long-term care facilities. Can the Minister tell me exactly how many long-term care residents in the Northwest Territories are in the system from Nunavut?
Thank you, Mr. Krutko. Minister Lee.
Thank you, Mr. Chairman. I don’t have the numbers on me right now, but some of them were ready before division. It’s not huge in numbers, but we have a few. So I will get back to the Member on the numbers. Thank you.
Back in I believe it was the 12th Assembly, there was a political decision to establish long-term care facilities in communities throughout the Northwest Territories, such as Aklavik, Deline, Fort Resolution, Gameti, and also Fort Simpson and throughout the Northwest Territories. I think one thing this government has to seriously look at is the economics of establishing these types of facilities where there are economic spinoffs for employment, job opportunities and benefits of these care facilities and the opportunities for jobs in our small communities.
Right now we have 40 to 45 percent unemployment in a lot of our communities. Looking at a facility such as the Joe Greenland Centre in Aklavik, it generates eight full-paying jobs in that community. Eight jobs in a small community, that’s a lot of economic stimulus to a small community. I noted that it seems like there’s a major shift towards the regional centres, but I’d like to know is this government seriously considering some sort of an economic shift to communities where we can offer these care providers in those communities and, more importantly, look at the social and economic benefit to the Northwest Territories in regard to the economics of making these political decisions? So I’d like to ask the Minister, has that been taken into consideration in light of these facilities being put in place by way of long-term care facilities?
I do appreciate what the Member is saying. The jobs or the positions or the people that are in our communities do serve in two different areas. Economically those are jobs and they have those jobs and those are important to them. Then in terms of care, it is so much more preferable for our people to be taken care of on our own. So I agree with the Member that there is room in our health care system, health and wellness, where we train and we have people in communities to take care of those who need assistance. Largely those are usually elders or they could be people with chronic conditions, they could be young people. We are having people with disabilities in small communities that need to be supported. So going forward, looking down 20, 30 years from now Canada-wide and in the NWT, not an exception, we need to have our people taking care of our people. That happens as home care support workers, wellness workers, those actually probably would have better economic return.
Our occupancy rate then, what we think of typically from a more acute care setting, because we still don’t have a lot of registered nurses or some of the other care members, they’re usually locums or fly-in staff. I mean, even communities the size of Fort Good Hope, Tulita, Lutselk’e, already we have a lot of nurses that are not locally from there, but I think our planning going forward could have a result that goes hand in hand of providing quality care on one side to our residents who need it and then care providers being from the communities. That’s possible under our long-term care model that we have developed. Thank you.
I believe that you have to look at the economics of the Northwest Territories and see exactly the have and have-not communities. I think one thing that you can clearly illustrate in those statistics or information that’s out there, I think most of our communities we have employment that ranges from 12 to 13 percent of people that make a pretty decent income, and you know who those 12 to 13 percent are. Those are professional providers in our communities. It’s either the nurses, the teachers or the RCMP. That’s the makeup of the 10 or 13 percent of those jobs in our communities.
Now, you have 45 to 55 percent unemployment with people making under $30,000 a year, which is almost 50 percent of your population. Something tells you there’s something wrong with that picture. When you have the large regional centres where you have almost 50 percent of your population making over $100,000 a year, there’s something telling you that this government is stimulating those economies.
Government is an industry, government provides that basic service model as so-called jobs, and for ourselves in our communities that is what we’d like to see this government really focusing on.
I know that you’re going to talk about national standards and everything else, but my view is the Northwest Territories is unique, it’s different, we have regional centres throughout the Northwest Territories, we have cultural distribution of different cultures throughout the Northwest Territories, we have geographical challenges. So I think that we have to be realistic when we do these things.
I do not support the direction this government is going. I strongly feel that you have to really be, when we’re making these capital decisions, what are the social impacts on the rest of the Northwest Territories when we make the decision to establish a long-term care facility, take it out of a small community, and make sure to realize that is going to have a long-term economic impact throughout the Northwest Territories, just not in those communities that are affected.
I’d like to ask the Minister, I know you mean well when you say you’re looking at home care workers, but those jobs don’t really pay as good as someone who is a caretaker in a long-term care facility or someone who is trained up to ensure you have a community health nurse on staff or the resources to assist those people. I’d like to ask the Minister why this government has not seriously contemplated the previous decisions of this government by looking at the demographic and population needs throughout the Northwest Territories and focus more on the need than the government continuing to grow at the regional centres and forgetting about the rest of the Northwest Territories.
